OBJECTIVE: The objective of this article is to analyze the kinematics and dynamics of restrained postmortem human surrogates (PMHS) exposed to a nearside oblique impact and the injuries that were found after the tests. METHODS: Three male PMHS of similar age (64 ± 4 years) and anthropometry (weight: 61 ± 9.6 kg; stature: 172 ± 2.7 cm) were exposed to a 30° nearside oblique impact at 34 km/h. The test fixture approximated the seating position of a front seat occupant...

INTRODUCTION: Subaxial spine injuries during infancy are uncommon. CASE REPORT: We present the case of an infant referred to our brachial plexus clinic with proximal weakness of both arms noted immediately following a complicated breech delivery. Nerve conduction studies were consistent with bilateral proximal upper plexus injury; however, radiological evaluation revealed a C4-C5 subluxation and MRI features of bilateral C5 root avulsions. He was immobilized in a cervical-body orthosis and underwent open reduction and posterior C4-C5-C6 fixation at 10 weeks age using luque rods, sublaminar wires, and rib graft...

In general, there are five lumbar vertebras in normal human subjects. But occasionally there are six. In such a situation, a radiologist need to discern between lumbarization of S1 (S1 vertebra becomes segmented and mimics L5) or due to hypoplastic 12(th) ribs, hence the T12 vertebra is wrongly assumed to be L1. These interesting images serve a multimodality approach to right aplasia/left hypoplasia of 12(th) rib, injury of left 11(th) rib and subluxation of left 11(th) Costovertebral joint in a patient with lumbar back pain...

Ultrasonography (US) is increasingly recognized as an important tool for diagnosis and therapeutic management of a variety of musculoskeletal conditions. Advantages of US use in the young athlete include the ability to diagnose dynamic conditions that are occult with other modalities, provide additional diagnostic information, and aid in treatment. Uses of US in young patients include evaluation of acquired musculoskeletal conditions that manifest with symptoms and assessment of congenital variants that may manifest with pain or limitations in activity...

Traumatic retropharyngeal pseudomeningoceles occur rarely, are associated with severe trauma, and have been reported in patients with significant neurologic deficits at presentation. We report the rare occurrence of a pseudomeningocele following a high-speed motor vehicle accident. Neurological examination showed the patient to be briskly following commands, with intact cranial nerve, motor, and sensory function. CT/MR imaging showed subarachnoid hemorrhage involving the interpeduncular cistern, a clivus fracture, a right occipital condyle fracture, an atlanto-occipital subluxation, aortic arch transection (stable and contained on CT angiogram), multiple rib fractures on the right side with associated pneumothorax, hemothorax and pulmonary contusions...

A 75-year-old woman with a history of myocardial infarction, gallstones, and right renal cancer was referred to our department because of right flank pain. She had a surgical scar on the right abdomen between the 10th and 11th ribs; computed tomography demonstrated intercostal herniation of the colon. Recognizing the possibility of adhesions of the hernia and colon, we used a median skin incision and patched a polyester mesh coated with absorbent collagen. The patient had an uneventful postoperative course, with no pain for 6 months postoperatively...

Posttraumatic spondyloptosis develops as a result of complete subluxation of the vertebral bodies and causes complete transection of the spinal cord. Severe trauma-related spondyloptosis of the upper-mid thoracic region is a rare form of spinal trauma. Traumatic midthoracic spondyloptosis is quite rare, and radiology plays an important role in the diagnosis and treatment of this condition. Surgical reconstruction and stabilization are required for early mobilization and rehabilitation of patients with this injury...

BACKGROUND: Skeletal dysplasias have been associated with upper cervical instability. Many patients are initially asymptomatic, but the instability may progress to subluxation and dislocation and complications thereof, including death. Surgery is hampered by petite osseous structures and low bone formation rate. AIM: To review the outcomes of surgical fusion of upper cervical instability in children with rare skeletal dysplasias. MATERIAL AND METHODS: A retrospective study of eight children with five different rare skeletal dysplasias needing upper cervical instrumented stabilization...

We present a case of a young man with a superior subluxation of an anterior end of the first rib following a road traffic accident. To the best of our knowledge, no similar case has so far been described in the literature. The patient presented with headache, backache and pain in the right anterior chest wall. After initial assessment, a chest radiograph was performed and it showed no abnormalities. A CT of the chest revealed an isolated hypermobile first rib at the anterior end owing to superior subluxation...

A radiographical study of a cat mummy from the Egyptian collection of the National Archeological Museum in Parma, Italy was carried out in order to evaluate the content and to describe how cats were wrapped and mummified. The mummy contained the complete skeleton of a 4-5-month-old cat. Radiology revealed the position of the cat's body; it was wrapped to occupy the smallest space possible. In order to better position the cat, the ribs of the thorax were compressed cranio-caudally and the fore limbs were then positioned very close to the thorax...

Focal pulmonary edema from increased venous hydrostatic pressure is most commonly seen in mitral valve regurgitation (in the right upper lobe) or in pulmonary venous obstruction/compression from neoplastic, fibrotic, or iatrogenic causes (in any lobe). We describe a case of focal pulmonary edema of the left upper lobe in a patient with partial anomalous pulmonary venous return of the left superior pulmonary vein, where the draining left brachiocephalic vein was compressed by a subluxed sternoclavicular joint after trauma...

BACKGROUND: Patients suffering from polytrauma often present with altered mental status and have varying levels of examinability. This makes evaluation difficult. Physicians are often required to rely on advanced imaging techniques to make prompt and accurate diagnoses. Occasionally, injury detection on advanced imaging studies can be challenging given the subtle findings associated with certain conditions, such as diffuse idiopathic skeletal hyperostosis (DISH). Delayed or missed diagnoses in the setting of spinal fracture can lead to catastrophic neurological injury...

BACKGROUND: Chylothorax is a rare form of pleural effusion that can be associated with both traumatic and non-traumatic causes. Thoracic duct ligation is often the treatment of choice in postsurgical patients; however the optimal treatment of this disease process after traumatic injury remains unclear 1. We present a rare case of a thoracic duct injury secondary to a blunt thoracic spine fracture and subluxation which was successfully treated non-operatively. CASE PRESENTATION: A 51 year old male presented as a tier one trauma code due to an automobile versus bicycle collision...

PURPOSE: This describes a child whose neonatal brachial plexus injury was treated with kinesiotape and exercise. DESCRIPTION: The subject was a two-year-old female whose X-rays demonstrated severe inferior subluxation of the humeral head and winging of the scapula on the left. She was fitted with a shoulder brace with surgery scheduled in six months. The initial PT exam noted 80 degrees of shoulder abduction (trumpet sign), significant asymmetry, and nonuse. Mallet score was 15/25...

STUDY DESIGN: A focused review of the literature with regard to the important system abnormalities of patients with spinal deformities associated with exotic congenital syndromes with additional data from the author's own experience in assessment of patients with rare syndromes treated for thoracic insufficiency syndrome. OBJECTIVES: The objectives of this study are to emphasize important medical considerations that influence the choice of surgical treatment of spinal deformity in patients with exotic congenital syndromes and point out preoperative strategies that reduce treatment morbidity and mortality of these patients...

There are several treatment options for rigid fixation at C1-C2 including Brooks and Gallie type wired fusions and C1-2 transarticular screws. The use of a Goel-Harms type fusion, a construct with C1 lateral mass screws and C2 pedicle screws, has not been extensively described in pediatric patients. Here, we describe its relatively safe and effective use for treating pediatric patients by retrospective chart review of patients treated by the senior author for atlantoaxial instability with a Goel-Harms-type constructs during a 3-year period (2005-2007)...

This case report details the diagnosis and treatment of a previously unreported complication of a congenital chest wall anomaly. Our patient presented with a painful anterior sternoclavicular joint subluxation secondary to a bicipital rib. Thoracic magnetic resonance and computed tomographic imaging provided the diagnosis. Complete resolution of symptoms was achieved after resection of the bicipital rib.

We describe a new method of stabilising a painful unstable sternoclavicular joint using the sternocleidomastoid tendon and passing it through the medial clavicle and onto the manubrium sternum. This method is simple, reproducible and avoids the potential risks of reefing the joint to the first rib. The technique was used in seven cases of sternoclavicular joint instability in six patients who were reviewed at a mean of 39.7 months (15 to 63). Instability was markedly reduced or eliminated in all cases, but in one there was occasional persistant subluxation...

BACKGROUND: Spinal cord compression and associate neurological impairment is rare in patients with scoliosis and neurofibromatosis. Common reasons are vertebral subluxation, dislocation, angulation and tumorous lesions around the spinal canal. Only twelve cases of intraspinal rib dislocation have been reported in the literature. The aim of this report is to present a case of rib penetration through neural foramen at the apex of a scoliotic curve in neurofibromatosis and to introduce a new clinical sign for its detection...

Participation in the sport of rowing has been steadily increasing in recent decades, yet few studies address the specific injuries incurred. This article reviews the most common injuries described in the literature, including musculoskeletal problems in the lower back, ribs, shoulder, wrist and knee. A review of basic rowing physiology and equipment is included, along with a description of the mechanics of the rowing stroke. This information is necessary in order to make an accurate diagnosis and treatment protocol for these injuries, which are mainly chronic in nature...